MIC-1及其多标志物联合对肠癌诊断分析

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目的巨噬细胞抑制因子-1(macrophages inhibitory cytokine-1,MIC-1)是近年来发现的一个广谱肿瘤标志物,广泛参与细胞凋亡、侵袭及转移等生物学过程。本研究旨在研究MIC-1在肠癌诊断中的价值,并探讨MIC-1、CA19-9和CEA多标志物联合用于肠癌检测可行性。方法选取2011-01-01-2014-12-30中国医学科学院肿瘤医院收治肠癌患者162例作为肠癌组,另选取同期300名健康体检者作为对照组。采用定量检测试剂盒分别检测162例不同临床分期未治疗肠癌患者和300名正常人群血清样本中的MIC-1、CA19-9和CEA水平,比较MIC-1与其他标志物、肿瘤患者临床分期的关系,以及在肠癌诊断与早期诊断的应用价值。结果肠癌患者血清MIC-1水平高于正常人群,P<0.001;且随临床分期进展呈上升趋势,并与TNM分期和患病部位呈现相关性,均P值<0.05。MIC-1诊断敏感性为53.7%,高于CA19-9(10.5%)和CEA(30.2%)。3种标志物联合检测敏感性为67.9%,MIC-1与CEA联合检测敏感性为66.7%。Logistic回归分析发现,肠癌诊断与MIC-1和CEA有关(P<0.001,P<0.05),回归方程转化的预测概率值ROC曲线AUC=0.915,约登指数最大为0.656,敏感性为92.6%,特异性为73.0%。结论 MIC-1对肠癌诊断具有重要临床辅助价值,多标志物联合联合检测能大幅提高诊断敏感性,适于正常人体检以及肠癌患者早期诊断。 Objective Macrophages inhibitory cytokine-1 (MIC-1) is a broad-spectrum tumor marker discovered in recent years and widely involved in the biological processes such as apoptosis, invasion and metastasis. The purpose of this study is to investigate the value of MIC-1 in the diagnosis of colorectal cancer and to explore the feasibility of combining MIC-1, CA19-9 and CEA markers for colorectal cancer detection. Method selection 2011-01-01-2014-12-30 Tumor Hospital of Chinese Academy of Medical Sciences patients with colorectal cancer treated 162 cases as colorectal cancer group, and the other 300 healthy subjects were selected as the control group. The levels of MIC-1, CA19-9 and CEA in serum samples from 162 patients with different clinical stage of non-treatment of colorectal cancer and 300 normal persons were detected by quantitative detection kit. The clinical stage of MIC-1 and other markers, tumor stage Of the relationship, as well as in the diagnosis and early diagnosis of intestinal cancer application value. Results The MIC-1 level in patients with colorectal cancer was significantly higher than that in normal controls (P <0.001). The MIC-1 level in patients with colorectal cancer was increased with the clinical stage and correlated with TNM staging and diseased sites (P <0.05). MIC-1 diagnostic sensitivity was 53.7%, higher than CA19-9 (10.5%) and CEA (30.2%). The sensitivity of the combined detection of the three markers was 67.9%, and the sensitivity of combined detection of MIC-1 and CEA was 66.7%. Logistic regression analysis showed that the diagnosis of colorectal cancer was associated with MIC-1 and CEA (P <0.001, P <0.05). The ROC curve predicted by regression equation was AUC = 0.915, the Youden index was 0.656, the sensitivity was 92.6% With a specificity of 73.0%. Conclusion MIC-1 is an important clinical adjuvant value for the diagnosis of colorectal cancer. Combined with multiple markers and combined detection, it can greatly improve the diagnostic sensitivity and is suitable for the early diagnosis of normal people and patients with colorectal cancer.
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